Individual
DR. TUCKER MARTIN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 MEDICAL CENTER DR # 117, FAYETTEVILLE, NY 13066
(315) 744-1505
(315) 214-1924
Mailing address
4000 MEDICAL CENTER DR # 117, FAYETTEVILLE, NY 13066-6631
(315) 744-1505
(315) 214-1924
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
258471
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03274408
—
NY
01
—
258471
LICENSE
NY
Enumeration date
07/11/2008
Last updated
10/13/2018
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